1. Field of the Invention
The present disclosure relates to medical instrumentation, and more particularly to a device for use with a uterine manipulator to facilitate laparoscopically sealing and resecting cervical and uterine tissue.
2. State of the Art
Typically a uterine manipulator is currently deemed necessary by practitioners for many laparoscopic procedures involving the female pelvic organs (e.g., uterus, tubes, ovaries, etc.) as surgery without a uterine manipulator may be more time consuming. For example, laparoscopies in which a uterine manipulator has substantial utility include: tubal ligations; diagnostic laparoscopies for evaluating pelvic pain and infertility; treatment of endometriosis, removal of pelvic scars (adhesions) involving the uterus, fallopian tubes and ovaries; treatment of ectopic pregnancy; removal of uterine fibroids; removal of ovarian cysts; removal of ovaries; tubal repair; laparoscopic hysterectomy, laparoscopic repair of pelvic bowel or bladder; sampling of pelvic lymph nodes; “tying up” the bladder to prevent urine loss; and biopsy of pelvic masses.
Most state of the art manipulators are semi-rigid instruments having a manipulating handle that is grasped outside the vagina and a working end which operatively engages one or more organs in the uterus. Exposure of the vital regions of the pelvis is difficult and surgery with open or laparoscopic instruments is often difficult and, in some cases, suboptimal. For example, the uterus typically can only be safely elevated about 45 degrees from the vaginal axis, or lowered 10-15 degrees from the same and movement to the right or left is minimal, at most, due to the pelvic bones. Once the uterine organ is in place, the surgeon can perform one of the above mentioned surgical procedures.
One of the most significant complications of any surgical procedure involving the uterus, e.g., partial or complete hysterectomy, is the risk of persistent and excessive bleeding due to the large blood supply in the pelvic region and blood-laden organs. For example, the open technique carries increased risk of hemorrhage due to the need to move the intestinal organs and bladder in order to reach the reproductive organs and to search for collateral damage from endometriosis or cancer. However, an open hysterectomy provides the most effective way to ensure complete removal of the reproductive system as well as providing a wide opening for visual inspection of the abdominal cavity.
Some hysterectomies are done through the manipulation of the cervix and/or uterus utilizing a uterine manipulator and resection of the cervix (total hysterectomy) or uterus (supracervical) utilizing one or more laparoscopic instruments inserted through the navel (or other body access made with a trocar). Even though these techniques tend to reduce the recovery time in most instances, there remains the risk of excessive and persistent bleeding which in this instance is not easily controlled due to the blood-laden nature of the cervix and the remote nature of the laparoscopy. As a result, if excessive bleeding does occur, the surgeon may need to convert the procedure to an open procedure to control the bleeding essentially abandoning the benefits of the laparoscopic procedure.